Adult Medication

Brand Names: US

D.H.E. 45; Migranal

Brand Names: Canada



  • Very bad and sometimes deadly poor blood flow to the hands, feet, or brain has happened when this drug was taken with certain other drugs like clarithromycin, erythromycin, indinavir, itraconazole, ketoconazole, nelfinavir, ritonavir, and troleandomycin. Do not take this drug if you are taking any of these drugs. There are many drugs that can do this. Check to make sure that it is safe for you to take this drug with all of your drugs.

What is this drug used for?

  • It is used to treat migraine headaches.
  • It is used to treat cluster headaches.

What do I need to tell my doctor BEFORE I take this drug?

  • If you have an allergy to dihydroergotamine or any other part of this drug.
  • If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
  • If you have any of these health problems: High blood pressure or some types of migraine headaches like hemiplegic or basilar migraine.
  • If you have any of these health problems: Blood vessel problems, chest pain or pressure, heart disease, kidney disease, liver disease, poor blood flow, very bad infection, or recent blood vessel surgery.
  • If you have ever had a heart attack.
  • If you have taken almotriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, or zolmitriptan in the last 24 hours.
  • If you have taken ergotamine, methysergide, or any drug like them in the last 24 hours.
  • If you are pregnant or may be pregnant. Do not take this drug if you are pregnant.
  • If you are breast-feeding. Do not breast-feed while you take this drug.
This is not a list of all drugs or health problems that interact with this drug.
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

  • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
  • If you drink grapefruit juice or eat grapefruit often, talk with your doctor.
  • Do not take more than what your doctor told you to take. Taking more than you are told may raise your chance of very bad side effects.
  • If you smoke, talk with your doctor.
  • Use care if you have risks for heart disease (high blood pressure, high cholesterol, overweight, high blood sugar or diabetes, cigarette smoking, man older than 40 years of age, other family members with early heart disease, woman after change of life). Talk with your doctor.
  • Very bad and sometimes deadly side effects like a heartbeat that does not feel normal, heart attack, stroke, and very bad high blood pressure have happened with this drug. Talk with the doctor.
  • Use birth control that you can trust to prevent pregnancy while taking this drug.
  • This drug may cause harm to the unborn baby if you take it while you are pregnant. If you are pregnant or you get pregnant while taking this drug, call your doctor right away.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Weakness on 1 side of the body, trouble speaking or thinking, change in balance, or blurred eyesight.
  • Chest pain or pressure or a fast heartbeat.
  • Numbness or tingling in the hands or feet.
  • Very bad dizziness or passing out.
  • Muscle pain or weakness.
  • Muscle cramps.
  • A heartbeat that does not feel normal.
  • Change in color of hands or feet from pale to blue or red.
  • Feeling cold.
  • Fast or slow heartbeat.
  • Swelling.
  • Very bad belly pain.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

All products:

  • Upset stomach or throwing up.

Nose spray:

  • Nose and throat irritation.
  • Change in taste.
  • Nosebleed.
  • Stuffy nose.
  • Runny nose.
  • Dizziness.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to your national health agency.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.


  • It is given as a shot into a muscle, vein, or into the fatty part of the skin.
  • Your doctor may teach you how to give the shot.
  • Follow how to use carefully.
  • Do not use if the solution is cloudy, leaking, or has particles.
  • Do not use if solution changes color.
  • Wash your hands before and after use.
  • Throw away needles in a needle/sharp disposal box. Do not reuse needles or other items. When the box is full, follow all local rules for getting rid of it. Talk with a doctor or pharmacist if you have any questions.

Nose spray:

  • For breathing by the nose. Prime pump by squeezing it 4 times. Breathe in 1 spray in each nostril. Wait 15 minutes. Breathe in 1 more spray in each nostril.

What do I do if I miss a dose?

  • This drug is taken on an as needed basis. Do not take more often than told by the doctor.

How do I store and/or throw out this drug?

Nose spray:

  • Store at room temperature. Do not refrigerate or freeze.
  • Once the nose spray is ready, throw away any part of the opened ampul not used after 8 hours.


  • Most of the time, this drug will be given in a hospital or doctor’s office. If stored at home, follow how to store as you were told by the doctor.

All products:

  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Check with your pharmacist about how to throw out unused drugs.

General drug facts

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else’s drugs.
  • Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor.
  • Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.

Last Reviewed Date



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